Sacral Stress Fractures



- Discussion:
    - insufficiency frxs of sacrum and pelvis may be confused w/ metastatic lesions, especially if bony resorption occurs at frx ends;
    - these injuries may also occur in patients with known malignant disease who have a sudden onset of pain in the lower back, hip, or groin;
    - they may occur with normal activities such as walking;

- Bone Scan:
    - useful in patients with insufficiency fractures;
    - look for vertical increase in uptake of radionuclide;
    - w/ bilateral fractures, an H-shaped distribution ("Honda sign");
         - pts who have these patterns should have follow-up CT scans through sacrum in order to confirm the diagnosis;

- Management:
    - complete healing may take upto 9 months;
    - patients require protected wt bearing in order to avoid late displacement and possible malunion;
    - patient also need to be protected from sacral decubiti



Occult sacral fractures in osteopenic patients.

Transverse fractures of the sacrum. A report of six cases.

Conservative management of transverse fractures of the sacrum with neurological features. A report of four cases.

Osteoporotic sacral fractures: a clinical study.

Sacral insufficiency fractures: an often unsuspected cause of low back pain.

Insufficiency fractures of the sacrum.

Magnetic resonance appearance of sacral insufficiency fractures.

Spontaneous osteoporotic fracture of the sacrum: an unrecognized syndrome of the elderly.
  
Unsuspected sacral fractures: detection by radionuclide bone scanning

Detection of osteoporotic sacral fractures with radionuclides.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, August 22, 2012 2:00 pm